Xylitol cavity prevention: How a mother's decay protection can be passed on to her child.

How the maternal consumption of xylitol can benefit the child.

There is another, seemingly mystical, anti-cavity benefit attributed to the long-term habitual consumption of xylitol products. This effect is one where tooth decay protection is afforded to children whose mothers have a history of consuming xylitol, even though the children themselves never have.

Consider the research performed by Isokangas (2000).

This study selected a group of mothers who were found to have statistically high levels of cariogenic (decay causing) bacteria in their saliva. A group of these mothers were instructed to begin regularly consuming xylitol (at a level of about 7 grams per day via the use of chewing gum) at a point three months after the birth of their child. At a point two years after childbirth, they were then instructed to terminate this regimen.

The children of these mothers were then examined on an annual basis for the presence of decay until the age of five. These examinations revealed that the children of mothers who had participated in the xylitol regimen experienced tooth decay rates that were in the neighborhood of 70% less than the children of mothers who did not.

When reading the above results keep in mind that the xylitol was only consumed by the mothers of the children, the children themselves never received any treatment. Also take notice of the fact that this maternal xylitol consumption was only started after the child was born.

A slightly different study, same general results.

To shed some light on the mechanism that is associated with this effect, we'll mention the results of another xylitol study.

Solderling (2000) selected a group of pregnant mothers who demonstrated elevated levels of cariogenic (decay causing) bacteria in their saliva. One subgroup of these participants was instructed to use xylitol chewing gum at least two to three times per day, starting three months after they had delivered their child.

The saliva of the children of all of the mothers was evaluated for the presence of cariogenic bacteria at specific points over the next two years. Note that it was only the mothers of the children who had the xylitol exposure, the children themselves did not receive any treatment. The children of the mothers who had consumed xylitol tested as having significantly reduced levels of cariogenic bacteria in their saliva, as opposed to the children of mothers who did not have the xylitol exposure.

A follow up study determined that even at age 6 the salivary counts of cariogenic bacteria in these children were still significantly lower. The assumption derived from this fact is that these children are at less risk for tooth decay formation because the numbers of cavity-forming bacteria in their mouths are lower.

So how does this mysterious anti-cavity protection take place when it is only the mothers of the children that received the preventive treatment? The answer has to do with how children initially acquire the bacteria that are responsible for causing tooth decay.

The mechanism by which maternal xylitol use provides cavity protection for the child.

The following theory provides an explanation of how a mother's consumption of xylitol can reduce the decay rate of her child.

In most cases, the bacteria that are responsible for causing tooth decay are initially acquired by children from their mothers via salivary contacts. This event typically takes place during that time period when the child's first teeth come in (age 6 through 30 months). The reason associated with this timing this is that the bacteria require tooth surfaces as a habitat.

It has been found that after the initial bacterial colonization of a tooth's surface has taken place, the continued presence of these bacteria is essentially permanent. Their replacement later on by other types of bacteria typically will not take place.

In the situation where the mother has a history of long-term, habitual xylitol consumption, it is proposed that the population of cariogenic bacteria in her mouth will be effected in one of the following ways.

Consumption of xylitol is known to inhibit the growth of cariogenic bacteria on a short-term basis. Additionally, studies have suggested that the long-term use of xylitol can cause a permanent reduction in the levels of these bacteria too. Since fewer cariogenic bacteria are present in the saliva of the mother, it is more difficult for these bacteria to be successfully transmitted to their children. This gives benign bacteria a greater chance of being the initial, and therefore long-term, colonizers of the surfaces of the child's teeth. This in turn creates a situation where the child is at less risk for tooth decay.
The long-term habitual use of xylitol appears to create a change in the type of cariogenic bacteria that live in the mother's mouth. A selection process takes place where xylitol-resistant strains of cariogenic bacteria become the dominant form, thus making it most likely that they will be the ones that will be transmitted from the mother to the child.
Xylitol-resistant bacteria are generally considered to be less capable of creating an environment that is conducive to tooth decay formation, as compared to xylitol-sensitive forms. This may be due to the fact that these bacteria are less capable of adhering to tooth surfaces, thus making it less likely that they can successfully colonize them.

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A mother's xylitol use can reduce her decay rate as well as her child's.

How the maternal consumption of xylitol can benefit the child.

A slightly different study, same general results.

The mechanism by which maternal xylitol use provides cavity protection for the child.